This week I had an interesting meeting with the district nurses where we learned:
- Intermediate care no longer exists.
- There is a new service called Home First. Home First includes a clinician and offers diagnostic services too – ‘No it doesn’t…’ – ‘Yes it does…’ – ‘I’m sure it doesn’t…’ – ‘Let me check that and I will get back to you…’
- There is a rapid-response team, but no one is sure what that is and how it differs from Home First – ‘Perhaps rapid response offers diagnostic services..?’ (See conversation above)
- Home response can deal with three or four people a day. What happens after that?
- A community matron is covering our practice to replace the community matron who stayed six months and who came after a one-year gap to replace the community matron who stayed six months who… you get the picture.
- The community matron cannot take referrals. The community matron will not visit the existing caseload. The community matron will call back patients on the existing caseload who left a message on her answer machine.
- The district nurse team is at full strength… unless you count the fact that two full-time nurses are on long-term sick leave.
- This replaces a system where you just spoke to someone on the phone.
Argh.
From Dr Mike Ingram, Radlett, Hertfordshire
